Ask HN: Is any ultrasonic aortic valve decalcification available to the public?

[ulnmd785]

Hello YC community. One of my close relatives has been diagnosed with calcific aortic valve stenosis recently. So, I'm looking for a non-invasive therapy to treat Calcific Aortic Stenosis (aortic valve decalcification).

What I found so far is focused ultrasound treatment for heart valve calcifications by Cardiowave, but their treatment is not available for the public yet. They did trials in France and The Netherlands.

Does anyone know similar treatment/ company/ organization / clinic who can be of any help?

[robbiep]

Speaking here as a Doctor the medical paternalism of this post may immediately disqualify My comments from some on this forum who have a tendency to aim to hack their own bodies the way they hack technology. So I apologise in advance should that reaction occur. However.

There are elements of your relatives case that make adequate commenting very difficult.

For instance, what is their age, what is their leaflet anatomy (bi or tri leaflet), what is the valve area, and is there calcification of the aortic root and what is their NYHA grade.

Aortic stenosis is a condition with high morbidity and mortality if untreated.

Elderly patients can do quite well depending on leaflet anatomy with transcutaneous aortic valve replacement (TAVI) - this is preferred for more elderly patients because the replacement valves don’t last as long as tissue or metallic valves (which last from 10ish to 30ish years respectively).

Due to the high morbidity and mortality associated with it, really the best thing your relative can do is listen to their cardiologist and cardiothoracic surgeon.

No-one really wants to have a zipper or go on bypass and it can be quite confronting but hunting down unproven miracle cures for a procedure that is exceptionally routine and has generally excellent results for patients with minimal comorbidities is a fools errand in my opinion

[unsrsly]

Disclaimer: this is not medical advice.

-The severity of aortic stenosis determines whether any intervention is indicated. Only a cardiologist or cardiac surgeon can reliably make this determination.

-The aortic stenosis procedure with the strongest evidence base is transcatheter aortic valve replacement, or TAVR. See the PARTNER 3 trial, https://www.nejm.org/doi/full/10.1056/NEJMoa1814052

-Bear in mind that only a cardiologist or cardiac surgeon can apply the available evidence to a patient and make a recommendation. In some cases of severe aortic stenosis, despite the PARTNER trials, an open surgical valve repair is still a better option. Only a cardiac surgeon can decide this after reviewing all of a patient's information.

-The evidence base for other interventions is weak. These options should probably not be considered outside of the context of a clinical trial. You can look for clinical trials here: https://clinicaltrials.gov/ct2/home

-Echoing other commenters, you should know that any procedure on the aortic valve has a risk of stroke. This would include any procedure that removes calcifications and possibly releases them into the blood. Only an interventional cardiologist or cardiac surgeon is qualified to discuss these risks in detail.

[ulnmd785]

Thanks for the information and for trials link

[Engineering-MD]

I would be wary of what you find in this search, especially here. Medicine and healthcare is hard, and novel treatments are frequent, but rarely actually work, and can cause significant harm. That’s why there are multiphase trials (1-3) and even then significant harm can slip through the net. From what I can see from a quick skim, this is very much still in trials (phase 1 at that) and not an accepted treatment. Why pursue an unproven treatment instead of the current standard? TAVI and surgical valve replacement are both suitable treatments for the majority.

I guess I just don’t see the reason for pursuing a treatment option outside of what is recommended by a specialist who has assessed the person in question.

[pvaldes]

IMHO you should look for the therapy that works better and is more extensively tested. If is more or less invasive, shouldn't be the main factor of choice.

I assume that removing a clot in the aortic by ultrasounds could have consequences when the debris accumulate in another part of the blood stream. This technology should be used with great care (probably, I'm not an expert in aortic plumbing) and probably in combination with anticoagulants. Ask a professional about by-pass and valve replacement instead.

Just an opinion. This is not medical advice and your mileage may vary. Think that if something goes wrong you will want a real physician close and the blood resources that only an hospital can provide ready to use.

[robbiep]

FYI bypass is for coronary arteries. Calcification of the aortic valve and root is something quite different

[halotrope]

Ivor Cummings is an engineer that investigated hearth disease based on first principles. He has made some interesting connections with diet and calcification. He always stresses that CAC scans are of vital importance. This interview is with someone who has successfully reversed a severely calcified Hearth Artery: https://youtu.be/OtyMr1WpPaI

[ulnmd785]

Thanks!

[Ireaditthere]

Pages 97-100 of “Vitamin K2 and the calcium paradox” by Kate Rheaume-Bleue, B.Sc., N.D. presents a clinical anecdote describing almost entirely reversing this condition in 10 months with daily supplement of 100 micrograms K2 MK-7 for a 69 year old man.

[wahern]

There's a double-blind, randomised, placebo-controlled study ongoing in Denmark exploring MK-7 as a treatment for AVC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112404/

EDIT: There was an earlier trial, https://clinicaltrials.gov/ct2/show/NCT01002157 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663571/), exploring MK-7 supplementation for CAC which should have been completed and the results published. The lack of published results doesn't bode well for efficacy.

EDIT: Here's a similar study for CAVD/AVC also still lacking results: https://clinicaltrials.gov/ct2/show/NCT02917525

[ulnmd785]

Many thanks for the resources!

[Ireaditthere]

At start of anecdote aortic valve area was 1.6 cm^2 ; at end it was 2.9 cm^2 ; the essay claims normal is 3.0 cm^2

[ulnmd785]

Thanks for the book!

[giantg2]

I think there's a diet and exercise regiment that is thought to stop and possibly reverse the calcification of arteries (and I assume valves). This probably isn't an option if his calcification is acute, which is usually the case because people only find out about it after a major event.

I think it goes without saying - do your own research and consult a physician. PubMed is a great resource.

[giantg2]

Not sure why this is downvoted. Even with other treatments, diet and exercise are still an important part of recovery and future prevention.

https://pubmed.ncbi.nlm.nih.gov/29074383/

https://pubmed.ncbi.nlm.nih.gov/29539583/

https://pubmed.ncbi.nlm.nih.gov/19772957/

https://swansonhealthcenter.com/health-issues/calcification-... (they don't list sources for everything)

[ulnmd785]

Thanks for the information!

[brian_herman__]

i think u should consult a doctor not news.ycombinator

[kyleee]

Sensible advice to be sure, but no need to preclude discussion here

[ulnmd785]

Totally agree.